Treatment for Men's Urination Problems in New Jersey

Aquablation® therapy is an option for men whose prostate enlargement cannot be effectively treated using prostate-shrinking medications. Aquablation therapy is performed using the AquaBeam Robotic System, guided by real-time imaging to deliver treatment with extraordinary precision. Aquablation therapy is indicated for any man whose prostate is causing an obstruction, and who cannot achieve relief with medication or do not want to take these drugs. Learn more about Aquablation.

"Aquablation therapy is as effective as these other treatments but with fewer side effects, including only a 10-15% risk of retrograde ejaculation," explained Ravi Munver, M.D., vice chair of Urology at Hackensack University Medical Center. "Because it is performed using the surgical robot with ultrasound guidance, it can be completed more rapidly, and with a level of precision that is reproducible from surgeon to surgeon. You can see where the prostate capsule ends and remove more excess tissue. Aquablation therapy is the only heat-free ablation approach available to treat BPH."

Here's how it works: The patient is asleep under anesthesia. An ultrasound probe is inserted into the patient's rectum to produce clear real-time images of the prostate. The addition of ultrasound imaging enables the surgeon to map the parts of the prostate to remove and the parts to avoid. The Aquablation scope is inserted into the urethra. When ready to begin, the surgeon presses on a pedal and the Aquablation system advances to the prostate, delivering a heat-free waterjet so intense that it can remove the prostate tissue that has been mapped out.

• Previous prostate treatment
• Urinary tract infections
• Bowel problems
• Prostate problems
• Kidney or bladder stones
• Neurological problems, such as Parkinson’s disease or stroke

• Stress incontinence: urine leakage caused by pressure on your bladder when coughing or sneezing
• Urge incontinence: when you feel a strong need to urinate
• Overflow incontinence: when your bladder becomes too full 

• Behavior and bladder training: This may include delaying urination to lengthen the time between trips to the toilet, learning to fully empty your bladder, and managing the amount and types of fluids you drink.
• Pelvic floor therapy: Our specially trained nurse will teach you to perform specific exercises such as Kegels that strengthen the muscles that control urination.
• Medications: A number of medications are available to help manage incontinence and overactive bladder.
• Percutaneous tibial nerve stimulation (PTNS): PTNS works by indirectly providing electrical stimulation via a nerve in your ankle to the sacral nerves responsible for bladder control. The stimulation gradually improves bladder activity. This outpatient treatment is delivered in weekly 30-minute sessions for about 12 weeks.
• Botulinum toxin type A (Botox®): Botox is injected into the bladder muscle to relax it and allow the bladder to fill with more urine before you have the urge to go to the toilet.
• Sacral nerve stimulation: A device like a pacemaker is implanted under your skin to deliver ongoing, painless electrical pulses to the sacral nerves involved in bladder control. Stimulating these nerves can control incontinence. This device may be implanted under the skin in your buttock and connected directly to the sacral nerves or may deliver pulses to the sacral nerves via a nerve in your ankle.
• Artificial sphincter: A device made of silicone rubber is placed around your urethra. The device can be inflated or deflated to control urination.
• Male urethral sling: A synthetic mesh-like surgical tape is placed under the urethra to provide support and prevent leakage of urine.

A visit to diagnose urination problems typically involves a comprehensive evaluation. This will likely include:

• A discussion of your symptoms and medical history.
• A physical exam, which may include a digital rectal exam (DRE) to check the prostate.
• A urine test to check for infection or other abnormalities.
• Depending on the initial findings, your doctor may recommend further tests like urodynamic studies (to see how well your bladder is working) or a cystoscopy (a thin camera used to look inside the bladder and urethra).

Hackensack Meridian Health offers a range of treatment options, including:

• Lifestyle Changes: Modifying fluid intake and diet.
• Medications: Prescribing drugs to relax the prostate muscles or shrink the prostate.
• Minimally Invasive Procedures: Advanced options like the UroLift® System (which lifts and holds prostate tissue out of the way) and Rezūm™ Water Vapor Therapy (which uses steam to reduce prostate tissue).
• Laser Surgery: Procedures like HoLEP (Holmium Laser Enucleation of the Prostate) to remove tissue that is blocking urine flow.